High-Resolution Magnetic Resonance Imaging of Aging Upper Face Fat Compartments

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The following comments refer to the article “High-Resolution Magnetic Resonance Imaging of Aging Upper Face Fat Compartments,” written by Foissac et al. (Plast Reconstr Surg. 2017;139:829–837).1 I read the above article with great interest and believe it would be helpful if some answers could be provided to the following queries.
The authors present information about the measurement of fat volumes in the second subdivision of the Methods section (Radiologic Study of Anatomical Fat Regions).1 Based on the work of Shen et al.,2 which was deemed appropriate for the imaging-based assessment of body compartments such as adipose tissue, fat volumes were calculated as follows (Fig. 1): V = (t + h) ∑Ai.
Shen wrote that the volume between two adjacent slices can be calculated by
in a truncated pyramid or a truncated cone, and by V = h (Ai + Ai+1)/2 in a parallel trapezium.
In Figure 1 of the article, however, the authors wrote, “Volume = (A1 + A2 + A3) × H.” A = measured area, H= same height between measured areas.” It is thought the volume in the schema of Figure 1 should be calculated otherwise, for example, Volume = {(A1 + A2)/2 + (A2 + A3)/2} × H.
The authors used the OsiriX imaging software, which is a useful picture archiving and communications system program available for Mac, to make measurements. As in other picture archiving and communications systems, the areas are measured freehand, not automatically. For freehand measurements to be made, the fat has to be discernible from the surrounding structures to the naked eye. To confirm the possibility of distinguishing the fat from the surrounding structures, a comparative study of histologic and magnetic resonance imaging findings should be carried out in advance, as has been done in other articles.

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